Sociodemographic Information, Aversive and Traumatic Events, Offence-Related Characteristics, and Mental Health of Delinquent Women in Forensic-Psychiatric Care in Switzerland
| DOI | 10.1177/0306624X17749638 |
| Date | 01 September 2018 |
| Author | Hedwig Eisenbarth,Michael Liebrenz,Sandy Krammer,Carole Fallegger,Dorothee Klecha |
| Published date | 01 September 2018 |
| Subject Matter | Articles |
research-article2017
Article
International Journal of
Offender Therapy and
Sociodemographic
Comparative Criminology
2018, Vol. 62(12) 3815 –3833
Information, Aversive and
© The Author(s) 2017
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Traumatic Events, Offence-
https://doi.org/10.1177/0306624X17749638
DOI: 10.1177/0306624X17749638
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Related Characteristics, and
Mental Health of Delinquent
Women in Forensic-
Psychiatric Care
in Switzerland
Sandy Krammer1, Hedwig Eisenbarth2,
Carole Fallegger1, Michael Liebrenz1,
and Dorothee Klecha1
Abstract
The present study describes a much understudied group—namely, female prisoners
under forensic-psychiatric care in the German-speaking part of Switzerland—to
improve understanding of their risks and their needs. Data were derived from internal
databases of a Forensic-Psychiatric Service. Data were collected in the form of their
sociodemographic characteristics, prevalence of aversive and traumatic events, type
of offence committed, and mental health conditions. Based on a ful -sample approach,
a total of 1,571 files were analysed. Results reveal that two thirds of the participants
were not in a stable relationship, more than half did not complete a school degree,
and three quarters were without stable employment prior to their incarceration. Two
thirds were mothers and about one third did not grow up with their parents. Almost
half grew up with an alcohol abusing parent, about half experienced violence and/or
neglect in childhood, and about a quarter of the cases sexual abuse. About 95% had a
mental health diagnosis according to International Classification of Diseases–Version
1Department of Forensic Psychiatry, Institute of Legal Medicine, University of Bern, Switzerland
2Department of Psychology, University of Southampton, UK
Corresponding Author:
Sandy Krammer, Department of Forenic Psychiatry, University of Bern, Falkenplatz 18, Bern 3012,
Switzerland.
Email: sandy.krammer@fpd.unibe.ch
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International Journal of Offender Therapy and Comparative Criminology 62(12)
10 (ICD-10), and the most prevalent mental and behavioural disorder was due to
psychoactive substance abuse. The most frequent offence type was drug-related
crimes. Women convicted for drug-related crimes were more likely to have an ICD-
10 F1 disorder compared with those convicted for other crimes. Conversely, women
with violent offences were less likely to suffer from ICD-10 F1 disorder than those
who had committed nonviolent offences. Findings have implications for practitioners
and policy makers, and contribute to the cycle of violence theory discussion. In
conclusion, future research areas are suggested.
Keywords
delinquent women, aversive and traumatic events, mental health, legal characteristics,
comorbidity
Background
Switzerland reports a rather low incarceration rate with about 84 prisoners per 100,000
inhabitants.1 In September 2015, there were a total of 6,884 prisoners, of which 5.5%
were female.2 Although the female incarceration rate remained rather stable between
1999 and 2015, there is a general underlying trend indicating a small annual increase.
There were 348 female prisoners in 1999, yet by 2015 the population had increased to
375. Still, these numbers indicate that incarcerated women represent a minority group
in Switzerland, similar to reports from many other countries. Across the world, about
half a million girls and women are incarcerated (Walmsley, 2006), and about 100,000
women in Europe on any given day (MacDonald, 2013).
Due to the low incarceration rate, research into female prisoners has been neglected
for a long time (Van Voorhis, 2012). More attention regarding this understudied group
has been recommended by the United Nations (Atabay, 2008) and the World Health
Organization (WHO; 2007). Hollin and Palmer (2006) have argued that gender-spe-
cific research of the prison populations should be undertaken for two reasons: First,
research is needed to inform services, so an adequate level of intervention may occur;
and second, to inform risk- assessment to avoid over- or underestimation of actual
risks.
Recent studies show higher levels of stress among imprisoned women compared
with nonimprisoned women, caused by mental and physical health problems as well
as social and interpersonal problems. For example, delinquent women are more likely
to report a lower level of education attainment than women from the general popula-
tion (Hollin & Palmer, 2006). Compared with male incarcerated groups, female pris-
oners have a less extensive and shorter criminal history (Hollin & Palmer, 2006), and
tend to commit less violent crimes (Carson & Sabol, 2013). Furthermore, imprisoned
women report more aversive and potentially traumatic experiences both during child-
and adulthood compared with the general population, as well as with the male popula-
tion in prison (McCabe, Lansing, Garland, & Hough, 2002; Messina, Burdon, &
Krammer et al.
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Prendergast, 2003). They also present higher rates of mental health problems such as
depression, psychotic illnesses, posttraumatic stress disorder (PTSD), borderline per-
sonality disorder (Coolidge, Marle, Van Horn, & Segal, 2011; Fazel & Baillargeon,
2011; Fazel & Seewald, 2012; Moloney, van den Bergh, & Moller, 2009), and atten-
tion deficit hyperactivity disorder (Coolidge et al., 2011), but lower rates of psychopa-
thy compared with incarcerated men (Salekin, Rogers, Ustad, & Sewell, 1998). All
this means that this subgroup has special needs that might not be currently provided by
a penitentiary service that is tailored for the male population.
Whilst, gender-specific data among prison population from different countries
around the world have been reported, information about female delinquents in
Switzerland is significantly scarce. The literature review revealed only six studies of
this specific prison group. Rossegger and colleagues (2009) investigated 16 women
convicted for violent crimes in the German-speaking part of Switzerland in a retro-
spective study. The participants reported more aversive childhood experiences, lower
education attainment, different offence-related characteristics, as well as a higher like-
lihood for having been in psychiatric treatment prior to offending compared with
matched men. Three retrospective studies (conducted in the French-speaking part of
Switzerland) revealed several gender differences regarding mental and physical health.
In a review of 1,510 files from remand prisoners, the female cases (76) presented
slightly more psychological symptoms or complaints than the male sample, including
anxiety and depressive disorders, except substance abuse (Eytan et al., 2011). Wolff
et al. (2011) studied 2,195 remand prisoners, of whom 108 were female, and found
similar gender differences regarding psychiatric problems (except for substance abuse)
but no differences regarding somatic health problems. Research conducted by
Moschetti et al. (2015) on 1,664 prisoners, of whom 140 were female, revealed that the
imprisoned females were more prone to mental health problems, including drug abuse
and infectious diseases. Krammer, Linder, Peper, Covington, and Klecha (2015) inves-
tigated 20 imprisoned women under forensic-psychiatric care in the German-speaking
part of Switzerland, and found that all participants experienced at least one traumatic
event. The prevalence of PTSD was 29%. Finally, Handtke, Bretschneider, Elger, and
Wangmo (2015) assessed the needs of 13 older female prisoners in comparison with
13 younger ones, and found that elder female prisoners reported poor quality of life,
difficulties regarding the provision of health care and the maintenance of social rela-
tions. Thus, the existing literature describing female prisoners relies on small samples,
and shows inconsistent findings regarding their health conditions.
Therefore, drawing from the research gaps identified, the aim of this study is two-
fold: first, to provide a detailed description of the female prison population in forensic-
psychiatric care in the German-speaking part of Switzerland by analysing (a)
sociodemographic data (e.g., age, education, employment status, civil status, mother-
hood, nationality), (b) offence-related characteristics (such as index offence or dura-
tion of imprisonment), (c) the prevalence of aversive and traumatic events (e.g., sexual
abuse), and (d) mental health conditions; and second, to test for statistical significant
differences regarding mental health and aversive or traumatic childhood events
between population subgroups: convicted violent offenders compared with convicted
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International Journal of Offender Therapy and Comparative Criminology 62(12)
nonviolent offenders, and female offenders for drug-related crimes compared with
those with other offences.
Method
Design, Setting, and Procedure
The present study reviewed and statistically analysed data collected by the Forensic-
Psychiatric Services (FPD) of the University of Bern in Switzerland. The FPD is
responsible for the treatment of female detainees in remand and prisons of the German-
speaking part of the canton Bern (Bern, Thun, Biel, Burgdorf), and the largest women-
only prison facility (Hindelbank) in Switzerland, with a capacity of 107 places.
Furthermore, the FPD provides treatment in an...
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